Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 227, Issue -, Pages 521-529Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jad.2017.11.024
Keywords
Affective disorders; Deep brain stimulation; Subcallosal cingulate gyrus; Cg25; Depression; Treatment-resistant
Categories
Funding
- Medtronic
- Medtronic Europe SARL (Meerbusch, Germany)
- Prof. Klaus Thiemann Foundation (Thiemann Fellowship)
- Stiftung Charite (Max Rubner Prize)
- Berlin Institute of Health (Clinical Scientist Programme)
Ask authors/readers for more resources
Background: Deep brain stimulation (DBS) of the subcallosal cingulate gyrus (SCG) is an experimental approach in treatment-resistant depression (TRD). Short-term results of efficacy in DBS are incongruent and studies investigating long-term effects are warranted. Methods: We assessed efficacy of SCG-DBS in eight patients randomized into a delayed-onset group (sham-DBS four weeks) and a non-delayed-onset group. The primary outcome measure was improvement on the Hamilton Depression Rating-Scale (HAMD-24-item-version). Response was defined as HAMD-24 reduction of at least 50% compared to baseline. Assessment was double-blind for a period of eight weeks and after 6,-12,-24,- and 28,months open-label. Results: The average improvement in HAMD-24 scores after 6,-12,- and 24-months were 34%, 25%, and 37%. After 6 months, HAMD-24 revealed a significant difference (P = .022) and 37.5% of the patients were responders. After 12 months, HAMD-24 scores dropped, but no significant difference was observed. After 24 months, a significant improvement was found (P = .041). After the four weeks lasting sham vs. DBS-ON period, there was no group difference (P = .376) in HAMD-24 and patients did not improve during sham stimulation. Patients were followed until 28 months and two up to 4 years under SCG-DBS and average response rate was 51%, whereas two patients were remitters (33,3%). Limitations: The small sample size limited the statistical power and external validity. Conclusions: Long-term improvement after SCG-DBS revealed a stable effect. There was no significant difference in response rates between the delayed and non-delayed-onset group. DBS for TRD remains experimental and longitudinal investigations of large samples are needed.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available